Joint H

ealth

FOR PROFESSIONAL USE ONLY

Lamberts®Nutrition

focus on:

Osteoarthritis is usually age related andcommonly affects people over 50, while thejoint inflammation and pain caused byrheumatoid arthritis frequently occurs muchearlier in life.

In people suffering from osteoarthritis, joints graduallylose their cartilage (the smooth, gel-like shock absorbingmaterial) that prevents adjacent bones from touching.Most commonly affected are the fingers, knees, hip,neck and spine. The onset is often gradual, marked bymild joint stiffness and pain, especially in the morningand following rest.

Rheumatoid arthritis is a chronic disorder in which thecartilage and other tissues in and around the bones becomeinflamed and damaged. Symptoms include fatigue, weightloss, low fever and joint stiffness, followed several weekslater by red and painful swollen joints (wrists, fingers, knees,ankles, and feet) that may feel warm.

Osteoarthritis may be the result of decades of joint wearand tear, though genetic factors, excess weight andimpairments in the body’s ability to repair cartilage mayalso play a role. In rheumatoid arthritis, the immunesystem attacks the body’s own joints and associatedtissues - the so-called autoimmune reaction. In somepeople this inflammatory condition, which often appearsbetween the ages of 20 and 40, may be the result ofgenetic predisposition.

Although osteoarthritis and rheumatoid arthritis havedifferent causes, there are many similarities in thesupplements used by practitioners.

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Nutrition focus on:

Joint HealthMore than 7 millionadults in the UK(15% of thepopulation) havelong-term healthproblems due toarthritis and relatedconditions.

54%

49%

32%

18%

11%

10%Aged 15-24

Yes, have arthritis or joint pain

Aged 25-34

Aged 35-44

Aged 45-54

Aged 55-64

Aged 65+

Base: Adults aged 15+ in Great Britain (2,031) Source: MORI

%

Do you have or have you ever had arthritisor joint pain?

Incidence of arthritis and joint pain

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GlucosamineGlucosamine is essential for maintaining healthycartilage, the smooth tissue that lines joints. Thereare no edible food sources of glucosamine, sowhen our bodies fail to manufacture sufficientnatural glucosamine, supplementation is useful tohelp maintain joint mobility.

One recent study indicated that glucosamine maybe particularly useful against arthritis in the knee.Two earlier studies found that glucosamine was atleast as effective as ibuprofen for relieving manydifferent types of arthritis symptoms.

Whilst glucosamine is available in various forms,glucosamine sulphate is the form that has beenrepeatedly and successfully used alone in studies.It has an exceptional absorption rate of 90 - 98%.The recommended dose is 750mg of glucosaminesulphate (equivalent to 1000mg glucosaminesulphate 2KCl), twice daily.

ChondroitinChondroitin sulphate is an important structuralcomponent of cartilage, the tough tissue that linesthe surfaces of bones, and forms a major part ofthe extra-cellular matrix that provides much ofcartilage’s resistance to compression. Chondroitinis thought to attract fluid into the cartilage and thisenhances its elasticity. It is also believed to inhibitthe proteolytic enzymes that break-down cartilage.

Chondroitin sulphate is now a popularsupplement worldwide, following a number ofpositive studies, and is usually combined withglucosamine as this compound works in adifferent but complimentary way.

Suggest 100mg daily but it is worth noting that acommon practice with chondroitin supplements isto use preparations that are just 20% chondroitin,but the label declares this as if it is 100%chondroitin. Therefore a supplement declared as‘400mg chondroitin sulphate’ is often just 80mg ofchondroitin sulphate.

MSMMany practitioners see methylsulphonylmethane(MSM) as a perfect partner to glucosamine. It is akey component of cartilage and plays an importantrole in joint health.

There is no dietary requirement for MSM but severalstudies have indicated that MSM supplementsmay be useful for some people as part of a jointcare regime.

Some companies currently supply petrochemicalMSM but there are some MSM products which are naturally sourced and the preferred form forpractitioners. The suggested dose is 1000mg ofMSM daily.

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Multivitamins &Minerals Several nutrients are necessary for the conversionof the fatty acids found in fish oil including the B vitamins and zinc. This is why most practitionersalso recommend taking a high strength multialongside fatty acid supplements.

Fish OilThe beneficial ingredients of fish oil are two fattyacids, EPA and DHA. These are omega 3 fattyacids, which as shown from clinical studies, areimportant in helping to maintain joint mobility.

In a complex process EPA and DHA are convertedinto prostaglandins that exert an anti-inflammatoryeffect. Research suggests that we need a dailysupplement of fish oil of the order of 2 to 3 gramsfor impaired joint movement.

Studies show that those with rheumatoid arthritiswho take daily fish oil supplements have fewertender joints and less morning stiffness. The firstimprovements were usually noticed after 12 weeks,and this increased further after 18 to 24 weeks ofsupplementation.

The omegas 3’s are also being researched becausefor many people their dietary intake has fallen to apoint that is low enough to be affecting their health.This is why the Government recommend that weeat some oily fish, such as mackerel, once a week,and many nutritionists think that it should be asoften as twice or three times a week.

BromelainBromelain, an enzyme derived from the stem of freshpineapples, is probably best known for its use as adigestive aid, especially to assist in the digestion offatty or high-protein meals.

Recent research however, has turned many experts’attention to its use for helping joint health. It isbelieved to inhibit the body's production ofprostaglandins associated with inflammation andpain whilst promoting the formation of those withan anti-inflammatory action.

Bromelain can also work well when taken inconjunction with turmeric so many practitionersrecommend taking the two products alongsideeach other. Bromelain appears to aid theabsorption of curcumin, the active compoundin turmeric.

To be of use a product must contain at least2000 gelatin-dissolving units (GDUs) pergram, which is why it is important to use a high strength product that containsthis relevant level.

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TurmericThe key active constituent in turmeric is curcumin,which is found within the root of the plant, and it is this part which is responsible for its brightyellow colour.

Studies have already shown how the key activeconstituent, the curcumins, in turmeric can inhibitthe compounds involved in the inflammatoryresponse. Consequently, practitioners oftencombine turmeric with glucosamine sulphate tocombat joint problems such as stiffness.

Similarly, turmeric is increasingly being added toformulations for back problems. However, almostall of these formulas provide only token levels ofthis spice. And to be of use you need to add arelevant level of turmeric root in extract form,which is why it is important to use a high strengthproduct. 500mg of root extract, standardised toprovide 95% curcumins, is the level generallyused in studies.

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Vitamin CVitamin C is needed for the manufacture of collagen,the protein that forms connective fibres in tissuessuch as ligaments, cartilage and muscles. Inaddition, cartilage cells appear to depend on highconcentrations of vitamin C. It is also an antioxidantneeded to protect cells, including those of thejoints, from damage.

Our daily requirement for vitamin C is higher than forany other water-soluble vitamin. Ideally, vitamin Cneeds to be taken in small amounts throughout theday and night because it is rapidly lost from thebody. However, this is not always convenient, whichis why time release vitamin C tablets (where thevitamin C is gradually released over approximately6 hours making the product longer acting), are sopopular amongst practitioners.

Other antioxidants such as vitamin E can also beused to help protect cells, including those of thejoints. 400iu once daily of natural source vitamin Eis the suggested dose.

GingerThis versatile root has an incredible range ofapplications that have proved useful to mankind. Inparticular, it is renowned for its usefulness for manygastrointestinal complaints. More recently however,ginger has soared in popularity with practitionersfor use in helping maintain healthy joints.

One study, showed that two-thirds of the volunteers(all with osteoarthritis of the knee) given ginger pillsreported relief from pain - significantly more thanthose taking a placebo.

The suggested daily dose is the equivalent of 14grams of fresh ginger root. Taking it in supplementform avoids the fuss and mess associated withpreparing fresh ginger.

NUTRIENTS Suggested Daily Dose

Glucosamine 750mg of glucosamine sulphate, twice daily Equivalent to 2000mg glucosamine sulphate 2KCl per day.

Chondroitin 100mg of Chondroitin Sulphate Choose marine sourced chondroitin as opposed to bovine chondroitin, which typically

comes from the trachea of cattle.

MSM 1000mg Look for a natural source of MSM as opposed to petrochemical MSM.

Fish Oil 1100mg of Pure Fish Oil, twice to three times daily Use fish oil that gives a guaranteed level of 700mg of omega 3’s and which quoteslevels of EPA & DHA at about 360mg and 240mg respectively.

Multivitamin & A broad-spectrum multivitamin and mineral complex Mineral Complex Several nutrients are necessary for the conversion of the fatty acids found in fish oil

including the B vitamins and zinc. This is why most practitioners also recommendtaking a high strength multi.

Turmeric 500mg root extract once or twice daily Use turmeric that is standardised to contain 95% curcumins.

Bromelain 500mg three times daily (1 between each meal) for one week. Thereafter a maintenance dose of 500mg daily can be taken for 3 to 6 months

The enzyme activity level should be 2000 GDU/g.

Vitamin C 1000mg of vitamin C daily A time release formula makes the product longer acting.

Ginger 120mg of standardised extract Equivalent to at least 14 grams of fresh ginger root.

Prescribers Guide to Joint Health

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